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Ophthalmology 2023 > Red eyes and red flags part 1 > Flashcards

Red eyes and red flags part 1 Flashcards

1
Q

red flags

A

multi trauma
red lids and red glove - could be orbital cellulitis or orbital haemotoma
unable to open eye
uveal prolapse
high intraoccqular pressure

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2
Q

what is high intraoocular pressure a red flag for

A

angle closure glaucoma

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3
Q

presentation of acute angle glaucoma

A

severe pain vomiting needing opoiods
associated headache
reduced vision
more common in south East Asians
more common in hyperopia

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4
Q

problems affecting lids and lashes

A

blepharitis, chalazion, stye, cellulitis

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5
Q

why does blephoritis happen during reading/working/driving

A

you blink less often when your concentration

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6
Q

recent surgery is a red flag for

A

endopthalmitis

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7
Q

uveal prolapse looks like

A
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8
Q

very high intraoccular pressur is a red flag for

A

acute angle glaucoma

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9
Q

previous episodes makes these conditions more likely

A

uveitis, keratitis, foreign body, seasonality, chalazion/stye

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10
Q

rheumatological disease makes thse conditions more likely

A

uveitis, episclertis, scleritis, dry eyes (Sjogren’s)

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11
Q

problems affecting the cornea

A

abrasion, FB, keratitis, chemical injury

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12
Q

recent dental work is a red flag for

A

orbital cellulitis

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13
Q

is stye is

A

an infected eyelash follicle

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14
Q

a chalazion is

A

non infective inflammation
collection of lipid secretion blocks a duct

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15
Q

a fixed mid-dilated pupil with high pressure and pain

A

angle closure glaucoma

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16
Q

white blood cells in the anterior chamber

A

uveitis

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17
Q

when to use topical anaesthetics

A

topical aneasthetic drops: minums oxybupricaine drops
dont put in if there is a globe rupture or penetrating foreign body

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18
Q

infective conjunctivitis aetiology

A

70% viral
30% bacterial
minority are chlamydia

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19
Q

treatment of chlamydial conjunctivitis

A

history of unprotected sex
will need swab and azithromycin

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20
Q

blood fluid level in the eye

A

hyphaema

21
Q

corneal involvement of conjunctivitis

A

punctate epithelial erosions

22
Q

management of conjunctivitis

A

hand hygiene
simple analgesia, ice packs, artificial tears
+/- conjunctival swab
topical decongestants
no antibiotic unless bacterial, no steroid
VA poor, protracted course, recurrent

23
Q

do you need antibiotics for normal bacterial conjunctivitis

A

dont need chlorsig unless severe
leading to antibiotic resistance

24
Q

do you need topical decongestant

A

eye can get addicted to it
maybe usee for a patient who has an important event

25
Q

if you suspect chlamydial conjunctivitis

A

you have to do a swab
cured with a single dose of azithromycin

26
Q

microbial keratitis Hx

A

severe pain, unilateral
reduced vision
hours to days
contact lens wearer or trauma

27
Q

aetiology of microbial keratitis

A

mainly gram positive
staph, pseudomonas, acanthomoeba

28
Q

hypopion

A
29
Q

management of microbial keratitis

A

oral analgesia
urgent ophthalmology referral
remove both contact lenses (save them for culturing)
corneal scrape (with anaesthesia), admission, intensive fortified broad spectrum topical antibiotics

30
Q

herpetic keratitis Hx

A

unilateral
associated rash, recurrence

31
Q

aetiology of herpetic keratitis

A

HSV1, VZV
UV exposure, concurrent illness, immunosuppression

32
Q

examination of herpetic keratitis

A

skin vessicles, shingles rash
Hutchinson’s sign - the tip of the nose is affected
fundoscopy

33
Q

hutchinson’s sign

A

lesions on the tip of the nose

34
Q

management of herpes simplex keratitis

A

topical antiviral
acyclovir ointment 5x per day
+/- oral acyclovir or valacyclovir
have to catch it within 72 hours for this to be effective
needs to be seen by opthalmology
oral analgesia

35
Q

management of herpes zoster opthalmicus

A

oral valacyclovirr for VZV
within 72 hours of onset
+/- topical antibiotic skin cream
referral to ophthalmology
oral analgesia
no steroids

36
Q

epiphora

A

watering

37
Q

corneal abrasion management

A

urgent referral to opthalmology if infection suspected
topical ABx
oral analgesia +/- patching
follow up within a week
no steroids

38
Q

removing a foreign body

A

topical anaesthetic
sterile cotton tip and/or fine gauge needle
ophthalmia burr for rust rings

39
Q
A
40
Q

episcleritis history

A

red eye +/- discomfort, lacrimation, no discharge
mild to moderate pain
recurrent
may have had a preceding illness

41
Q

aetiology of episcleritis

A

idiopathic
metabolic eg. gout
infectious
collagen-vascular / rheumatological condition
usually unilateral main differential is scleritis

42
Q

management of epislceritis

A

topical steroids
oral NSAIDs
referral to ophthalmology
review more urgently is you’re worried it’s scleritis

43
Q

photophobia, cells in the anterior chamber, unusual eye shape

A

acute anterior uveitis

44
Q

history of acute anterior uveitis

A

photophobia, floaters, blurred vision
unilateral, sub-acute
rheumatological disease

45
Q

aetiology of acute anterior uveitis

A

ankylosing spondylitis (HLAB27)
idiopathic
inflammatory, infective, malignancy

46
Q

examination of acute anterior uveitis

A

limbal injections, AC cells, hypopyan (if it’s really bad)
keratin precipitates, posterior synechiae
pain on examining the unaffected eye (shine a torch into the good eye, pupil constricts on the bad eye causing pain)

47
Q

management of uveitis

A

refer to ophthalmology +/- rheumatology (to investigate for underlying rheumatological disease)
sunglasses
investigate for underlying disease
topical steroids (sometimes injected steroids or systemic immunosuppression)

48
Q

things that are threats to sigh or life

A

orbital cellulitis
severe trauma
retrobulbar haemorrhage
microbial keratitis
acute angle closure glaucoma

Ophthalmology 2023 (18 decks)

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